Prevention is central to a range of Scottish Government policies, including the Population Health Framework, Cash-First: Towards Ending the need for Food Banks and will help us in Scotland to achieve a Good Food Nation. But what does prevention actually mean in practice? And what role does the community food sector play in delivering it?

What does prevention mean?
In public health, prevention is about helping people stay healthy and reducing the risk of poor health, illness and early death. Public Health Scotland (PHS) highlights prevention as a key approach to tackling longstanding public health challenges and reducing health inequalities. It acknowledges that the term prevention can be used in different ways which can be confusing.  To clarify this, PHS outlines three levels of prevention: primary, secondary and tertiary prevention.

Primary Prevention: stopping problems before they start
Primary prevention aims to prevent harm before it happens. It focuses on creating the conditions that support good health, such as access to quality housing, healthcare, education, fair employment and social connections, referred to as the “building blocks of health”.

The wider community and voluntary sector make an important contribution to primary prevention by using community-led or community development approaches and supporting people to build skills, confidence and to develop communities and resources.

Many community food initiatives (CFIs) offer training in areas such as cooking, nutrition, gardening and food safety, alongside volunteering opportunities and pathways into employment. Community cafés, growing projects, shared meals and cooking groups can help reduce social isolation, strengthen community connections and provide access to good, nutritious food. These activities are often open to everyone but may have a particular focus on engaging people who face greater barriers to health and wellbeing.

Secondary Prevention: identifying risks early
Secondary prevention focuses on identifying risks and providing support before problems become more serious.

For CFIs, this may involve improving access to affordable and nutritious food in areas where healthy food options are limited. Community food outlets, community cafés and local growing projects can help people access fresh and affordable produce.

Secondary prevention can also target groups who are known to be at higher risk. For example, elderly people may be vulnerable to social isolation or malnutrition. A CFI might respond by offering lunch clubs, community cafés, meal or shopping delivery services, combined with befriending opportunities. These types of activities can help prevent problems from escalating and support people to maintain their health and independence.

Tertiary Prevention: reducing the impact of existing problems
Tertiary prevention aims to reduce the impact of problems that have already developed by carefully managing these.

Many CFIs are involved in supporting people experiencing food insecurity, financial hardship and poor health. This may include providing dignified access to food aid, running food pantries or offering low-cost food options. Alongside community food provision, organisations might aim to manage these problems by signposting people to financial support and advice and by providing more holistic support that can help address the underlying causes of people’s problems.

CFIs also support people who are managing long-term health conditions. For example, cooking groups that provide tailored nutritional advice can help people with conditions such as diabetes help manage their health as well as meet others with similar challenges.

All three levels of prevention are important, but only primary prevention will prevent a problem from happening in the first place. In practice, CFI activities might overlap across more than one of these levels.

Looking ahead
Overall, a stronger focus on prevention could be good news for the community food and wider community and voluntary sector. The Scottish Government’s Population Health Framework recognises that shifting towards prevention requires investment and highlights the important contribution of the community and voluntary sector. Community food initiatives are well placed to support prevention because they take a holistic, community-led approach to improving health and wellbeing.

However, it can be hard to explain or demonstrate the wide-ranging impact of community food work. In the next blog about prevention, we will explore how community food initiatives can evaluate and articulate their contribution to preventing poor health and reducing health inequalities.

Further information
You can read more about the public health approach to prevention on the Public Health Scotland website.

Edinburgh Community Health Forum, Health and Social Care Alliance Scotland (the ALLIANCE), Scottish Community Development Centre (SCDC) and CHEX, and Voluntary Health Scotland issued a joint statement on the importance of prevention. You can read the joint statement on the SCDC website.

Evaluation Support Scotland has produced resources to support the third sector to evaluate prevention. You can find these on the Evaluation Support Scotland website.